Nipple shields-the super thin silicone nipple worn over mom’s nipple during feedings at the breast; have you heard of them? Maybe a friend told you that she used a nipple shield for the first week when her baby nursed or maybe you think you have flat nipples, so you bought one while pregnant or, more commonly, maybe a well-meaning nurse gave you one in the hospital when your new baby had difficulty latching to the breast. Information still circulates warning against them, but is that warning really warranted? The truth is, the nipple shield can be a wonderful tool, but they are only temporary fixes to underlying issues. They are a tried and true option to preserve the breastfeeding relationship when used in the right circumstances and under the supervision and guidance of a lactation professional like an IBCLC.
So when should you use one? Nipple shields can be useful when there are breastfeeding challenges either with mom and/or baby. At about $10 a shield and available at most big box stores, they are an affordable option when faced with obstacles that could otherwise end the breastfeeding relationship.
When Baby Can’t Latch
Nipple shields are helpful for the baby with a tongue or lip tie (until revision) as they allow the baby to grasp the breast and actively remove milk. They are also helpful for the late preterm infant. These early babies have difficulty coordinating their suck, swallow, breathe reflexes and the shield can allow for an easier latch and therefore removal of milk. In conjunction with adjusting holds and maturation of the breastfeeding relationship while following your lactation support's guidance, the shield can bridge the gap between challenging feed scenarios and a normalized breastfeeding process.
When Mom Needs Help
An IBCLC might also recommend the use of a nipple shield when an improper latch has painfully damaged the nipple(s). When I hear a mom say “I just can’t imagine putting her on the breast one more time, it hurts so bad”, then (following a comprehensive assessment) I may very well pull out a shield. Nipple shields can allow just enough relief for mom to go on breastfeeding as she simultaneously works on correcting her baby’s latch.
While it’s true that babies can usually make a teat from their mother’s nipple and breast tissue, inverted (or truly flat) nipples can sometimes, but not always, call for the use of a nipple shield. The firm teat of the nipple shield acts to stimulate baby's deep latch and suckle. Suckling on a nipple shield can often evert an inverted nipple too.
Work with a Pro
If you suspect you may need to temporarily use a nipple shield, be sure to work with an IBCLC. She will teach you how to not only put one on correctly, but will ensure you get a deep and sustained latch. Along with this an IBCLC can help to create a plan for weaning your baby from the shield; remember it's only a temporary fix.
A sometimes overlooked step in properly incorporating a nipple shield is providing baby with the appropriate motivation to deeply latch. After correctly applying the shield (check out this handy video), hand-expressing a little milk into the tip of the shield can entice a baby to take the shield at the breast with a wide, deep latch. Utilizing a shield incorrectly and/or inefficiently may not only delay your goals but could create additional challenges to overcome.
In order to properly establish and maintain nipple shield utilization I highly encourage moms to leverage professional lacation support mechanisms (in person, or virtually via a service such as Milk on Tap). An in-person consult with a well-equipped IBCLC can ensure pre and post-feed weights to ensure your baby is effectively transferring milk. An IBCLC (local or virtual) can also follow up frequently to monitor your baby’s weight gain while using the shield. Most importantly, an IBCLC will work with you to resolve the underlying issue so you can eventually (and hopefully quickly) go on to breastfeeding without it!